U.S. — The Department of Health and Human Services (HHS) launched the "Make Hospital Food Healthier" Pledge on Wednesday. The voluntary initiative encourages hospitals to limit ultra-processed foods and sugar-sweetened beverages in patient meals.

"Patients recovering from serious medical conditions deserve better than ultra-processed and deep-fried junk foods," HHS Secretary Robert F. Kennedy Jr. said. "Today, we're challenging hospitals across the country to lead by example by serving nutritious, minimally processed meals that help patients heal, reduce chronic disease, and help make America healthy again."

Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services, said, "When it comes to managing chronic disease, reducing comorbidities like obesity, and shortening recovery times, a healthy diet can make all the difference." He added, "Hospitals should nourish patients with the same commitment they bring to every other aspect of care." Oz stated, "That's why we're challenging hospitals to limit ultra-processed foods, feature nutritious meals that promote healing, and lead the way in delivering prevention-first, whole-person care."

The pledge commits hospitals to limit processed meats and foods high in added sugars, sodium, and artificial additives. It encourages baking, broiling, roasting, stir-frying, or grilling instead of deep frying. The initiative prioritizes minimally processed proteins, including plant-based options, and emphasizes whole grains over refined grains.

CMS sent a special alert to hospitals at the end of March reminding them of their obligation to meet patients' nutritional needs and to limit serving ultra-processed foods and sugary beverages to chronically ill patients. In January, the Trump administration released new dietary guidelines advocating for fresh vegetables, whole grains, and dairy products while urging consumers to avoid packaged, prepared, ready-to-eat, or other salty or sweet foods. Ultra-processed foods account for more than half of the calories in the U.S. diet and have been linked to chronic diseases like diabetes and obesity.

Kevin Klatt, associate editor of the American Journal of Clinical Nutrition, said, "In the rationale laid out in the [special alert], CMS cites prospective cohort studies that detail the association between self-reported dietary intakes in the general population and risk of chronic disease." He stated, "This type of evidence can inform clinical nutrition guidance, but often is inappropriate for the unique nutritional considerations and goals of the inpatient setting." Klatt cited examples including stroke patients with swallowing difficulties, chemotherapy patients experiencing nausea, and gastrointestinal surgery patients with high energy and protein needs but limited digestive capacity. "These are just a handful of examples of patients who have altered nutritional requirements and unique barriers to intake," he said.

Klatt questioned the memo's impact, stating, "As nutrition advocates, we should question whether this memo is really a nutrition 'win' and critically examine the (lack of) serious policies and proposals that this administration has for addressing our current food system, which promotes nutrition-related chronic disease." He added, "To the extent that hospital nutrition needs improvements, it is a symptom of the broader food environment that we've seen no plan for tackling from this administration."

Klatt noted the pledge softened language compared to the special alert by encouraging hospitals to emphasize whole grains rather than eliminate refined grains. "This doesn't change too much but I think the softening of tone is probably related to pushback," he said. Klatt also noted there remains no clear distinction between food service for patients and retail food options in hospitals. "The pledge could have been much more effective if they encouraged hospitals to not sign contracts with companies for their retail food space who largely serve options that are predominantly misaligned" with the dietary guidelines, he said.